Provider Demographics
NPI:1861571465
Name:MICHAEL FRANK SCHLAACK MD LTD
Entity type:Organization
Organization Name:MICHAEL FRANK SCHLAACK MD LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:SCHLAACK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-263-4555
Mailing Address - Street 1:105 N PECOS RD
Mailing Address - Street 2:STE111
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7324
Mailing Address - Country:US
Mailing Address - Phone:702-263-4555
Mailing Address - Fax:702-263-4671
Practice Address - Street 1:105 N PECOS RD
Practice Address - Street 2:STE111
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7324
Practice Address - Country:US
Practice Address - Phone:702-263-4555
Practice Address - Fax:702-263-4671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4845207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVC96544Medicare UPIN
NVVWCHFBMedicare PIN
NV08WCHFB08Medicare ID - Type UnspecifiedLEGACY MEDICARE NUMBER